A new study published in Journal of Hepatology has shown that the steroidal FXR agonist PX20606 decreased portal hypertension in experimental models of both non-cirrhotic and cirrhotic portal hypertension by targeting the combination of liver fibrosis, vascular remodelling and sinusoidal dysfunction. Treatment with PX20606 in rats with either non-cirrhotic or cirrhotic portal hypertension led to reduced fibrosis, improved blood flow in the liver (the agent induced sinusoidal vasodilation and reduced intrahepatic vasoconstriction) and restored endothelial function. In addition, intestinal inflammation and bacterial translocation was reduced. The authors conclude that synthetic FXR agonists such as PX20606 could be promising novel treatment options for portal hypertension.